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Emergency Risk Communication Principles and Applied Practices

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Emergency Risk Communication Principles and Applied Practices Melinda Frost, MA, MPH Health Communications Officer US Embassy, Beijing * Emergency Preparedness Forum ... – PowerPoint PPT presentation

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Title: Emergency Risk Communication Principles and Applied Practices


1
Emergency Risk Communication Principles and
Applied Practices
  • Melinda Frost, MA, MPH
  • Health Communications Officer
  • US Embassy, Beijing

2
Presentation Outline
  • Emergency and Risk Communication Definitions
  • Emergency Risk Communication Principles
  • Emergency Risk Communication in China
  • Developing an Emergency Risk Communication Plan

3
Definitions
  • Risk Communication communication about potential
    (uncertain) health risks to support informed
    decisions
  • Emergency a health threat in which urgent
    response is required

4
Why? Emergency Risk Communication
  • To provide accurate and timely information as
    well as essential coordination during an emergency

5
Why? Emergency Risk Communication
  • To inform the public of potential risks and steps
    being taken during an emergency

6
Why? Emergency Risk Communication
  • To aid individuals, stakeholders, or communities
    to accept the imperfect nature of choices and to
    make best possible decisions during an emergency

7
Emergency Communication Challenges
  • Uncertainty
  • High potential for altered or conflicting
    recommendations
  • People are looking at multiple channels to check
    on rumors

8
THE CERTAINTIES OF COMMUNICATING UNCERTAINTY
  • You will be tempted to suppress your uncertainty
    and sound confident its human nature
  • Things will turn out better if you resist that
    temptation

9
THE CERTAINTIES OF COMMUNICATING UNCERTAINTY
  • Over-confidence rings false, undermining everyone
    elses confidence even if you turn out right
  • Over-confidence provokes acrimony, especially
    among your critics
  • Over-confidence devastates your credibility and
    your ability to lead if you turn out wrong

10
  • Emergency Risk Communication Principles

11
WHO Outbreak Communication (Emergency Risk)
Principles
  • Trust
  • Announce early
  • Transparency
  • Listen to and involve the public
  • Planning

12
Accuracy of Information

Speed of Release
  • Credibility
  • Trust

Successful Communication

Empathy Openness
13
Components of Trust
  • The public perception of
  • Motives
  • Are responders acting to protect my health and
    the health of my family?
  • Honesty
  • Are the responders holding back information?
  • Competence
  • Are the responders capable of controlling the
    outbreak?
  • Trust must come before the crisis

14
Announce Early
  • First Announcement
  • The most critical of all outbreak communication
    messages
  • Must be early
  • Likely to be wrong

15
Transparency
  • Barriers to Transparency
  • Real or perceived competing interest (economic
    vs. public health)
  • Spokespersons uncomfortable with delivering bad
    news

16
Transparency
  • Barriers to Transparency
  • Fear the media will misrepresent bad or uncertain
    news
  • Concern the public cant tolerate uncertainty or
    will panic
  • Official belief that if you say nothing, nothing
    will happen

17
Listen to and involve the public
  • State continued concern before stating updates
  • Acknowledge uncertainty
  • Emphasize a process in place
  • Tell people what to expect
  • Give people things to do
  • Let people choose their own actions
  • Ask more of people

18
Listen to and involve the public
  • Dont try to allay panic
  • Acknowledge peoples fears
  • In every message, try to use
  • Empathy
  • Action
  • Respect

19
Influenza A H1N1 Communication Response Announce
Early, Transparency Trust
  • First cases laboratory confirmed 4/15 - 17
  • 4/22 Activation of Emergency Operations Center
    (http//www.cdc.gov/h1n1flu/)
  • 4/23 Daily press briefings (http//www.cdc.gov/h1n
    1flu/press/)

20
Risk Communication Principles Project Background
  • Public Health Emergency Risk Communication Draft
    Guidelines and Handbook

21
Risk Communication Principles Project Background

March 09 Preliminary Handbook Table Top
Sept 10 Final Handbook Table Top
October 06
November 07 Draft Guidelines
Dalian Workshop
Nov 06-Jan 07
2007-08 Training of Draft Guidelines
Review of Risk Communication Principles
2009-10 Re-draft of Risk Communication Handbook
22
Risk Communication Principles
Pilot Training and Testing
January 07 March 08
Fujian Province Guizhou Province Jiangsu Province
23
China MoH US CDC Emergency Risk Communication
Activities, 2006 2008
  • Pilot Training and Testing
  • Provinces
  • Fujian
  • Guizhou
  • Jiangsu
  • Training completed in 2007
  • Anhui
  • Chongqing
  • Guanxi
  • Hubei
  • Liaoning
  • Shanghai
  • Yunnan
  • Training scheduled for 2010-11
  • Beijing
  • Hebei
  • Heilongjiang,
  • Zhejiang,
  • Sichuan

24
Testing and Training of Effective Risk
Communication Principles
  • In Fujian Province (Jan 2007), Guizhou and
    Jiangsu (Mar 2008) activities in to test
  • Was training on the risk communication principles
    effective?
  • Are risk communication principles effective for
    Chinese public?

25
Risk Communication Principles Project Protocol
  • Step 1 Health officials wrote public health
    messages based on a hypothetical case study
    involving a 3-stage H5N1 scenario.
  • Step 2 Trained on Risk Communication Principles
    and Practice
  • Step 3 Message revision based on principles and
    training
  • Step 4 Message testing with citizen groups

26
The risk communication training was effective
  • Post-training messages
  • More risk communication principles
  • More types of principles to address psychological
    functions of risk communication
  • Decrease feelings of uncertainty and fear
  • Increase feelings of control
  • Increased trust in health authority
  • Address publics cognitive needs

27
Guizhou health care workers wrote messages that
included this many Risk Communication principles
28
Jiangsu health care workers wrote messages that
included this many Risk Communication principles
29
Combined provincial health care workers wrote
messages including this many Risk Communication
principles
30
Risk Communication Principles Message Testing
Results
184 Citizens
31
Risk Communication Principles Message Testing
Results
32
What the Public Wants to Know
  • Feedback from Fujian Province Audiences
  • How can I prevent getting the disease?
  • How is the disease transmitted?
  • Is what Im hearing about the disease true?
  • What is the disease? And how serious?
  • What is the government doing to prevent the
    spread of disease?
  • Where can we go for more information?
  • Is there a vaccine available?
  • Topics from US Audiences
  • What is the health threat?
  • How does it harm people?
  • How will I know if Ive been exposed?
  • Signs and symptoms (long/short term)
  • How can I protect myself/my family
  • How is it treated?
  • Where can I get more information?

33
Where are People Going for Information?
  • Television news
  • CCTV
  • Newspapers
  • Website
  • Health bureau, News Website, Sina.com,
    Xinhua.com, MSNBC.com, Baidu search engine
  • Local health bureau
  • Community residents committee
  • Telephone line for public inquiries (hotline)
  • Local health department, national hotline
  • CDC
  • Local hospital
  • Emergency Center
  • Neighbors

34
Channels Used by The Public to Seek Emergency
Information
  • Distant threat passive channels
  • TV news, newspaper
  • Threat is close by, but not in our community
    more active information seeking, but impersonal
    channels
  • Internet, Website, Search engines
  • Threat is here pro-active search through
    interpersonal channels
  • Hotlines
  • Visit local health bureau
  • Call hospital
  • Visit or call local community residents center
    and committee
  • Call CDC

35
Emergency Risk Communication Lifecycle
Pre-crisis
Initial
Maintenance
Resolution
Evaluation
  • To facilitate and anticipate the needs of the
    public, the media, and partners at different
    stages
  • Each stage has unique communications and
    information requirements

36
Pre-Crisis Communication
  • Be prepared
  • Foster alliances
  • Develop recommendations through consensus
  • Test audience messages

Pre-crisis
37
Planning
  • Communicators
  • Technical staff
  • Policy makers

Communicators
Tech staff
Policy makers
38
Nine Steps of Communication Response
4
3
5
2
6
1
7
8
9
39
Public Information Release
  • Select the appropriate channels of communication
    and apply them
  • Simply
  • Timely
  • Accurately
  • Repeatedly
  • Credibly
  • Consistently

40
Trust Case Study
  • Measles, Mumps Rubella Vaccine (MMR)
  • United Kingdom, 2008

Raithatha N, Holland R, Gerrard S, Harvey I, A
qualitative investigation of vaccine risk
perception amongst parents who immunize their
children a matter of public health concern. J.
of Public Health Medicine. 25 (2) 2003
41
MMR Vaccination in the UK What happened?
  • In 1998, a researcher suggested that the MMR
    vaccine may cause autism
  • In 2001, the same researcher developed another
    paper questioning the safety of MMR

42
MMR Vaccination in the UK What happened?
  • The media reported the paper out of proportion
  • Subsequent papers and studies have disproved the
    link between MMR and autism

43
Context in the United Kingdom in early 2000s
  • Parents understood true benefits of vaccination
    but still felt dread at thoughts of long-term
    disability
  • Lack of trust in recent government
  • reaction to BSE crisis
  • Slight lack of trust in motives, and knowledge
    base of doctors

44
MMR Vaccination in the UKThe Results
  • MMR Vaccination rates dropped from 91 to 80
    between 1998 and 2004
  • 1,049 cases of measles between Jan Oct, 2008
    (the worst year since 1995)
  • 55,000 cases of mumps between 2004-06

45
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46
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47
Audience Perceptions and Rumors
  • A rumor is a specific (or topical) proposition
    for belief, passed along from person to person,
    without secure standards or evidence being
    present.

48
Rumor sources
  • Blogosphere
  • SMS text messaging
  • Internet
  • Word of mouth
  • Where else?

49
Audience Perceptions Sources of Insight
  • Monitoring for rumors (listening to your
    audience)
  • Social media websites,
  • blogospheres
  • Hotlines (12320, hospitals, etc.)
  • Print/broadcast media

50
Audience Perceptions Sources of Insight
  • Listening to your audience
  • Focus groups
  • Intercept interviews
  • What else?

51
Rumor found to react or ignore?
  • The two factors that influence a rumor are its
    importance to the listener and its ambiguity.
  • Rumors travel when events have importance in the
    lives of individuals, and when the news received
    about them is either lacking or subjectivity
    ambiguous. The ambiguity may arise from the fact
    that the news is not clearly reported, or from
    the fact the conflicting versions of the news
    have reached the individual, or from his
    incapacity to comprehend the news he receives.

52
How do we address misinformation?Risk
Communication Principles
  • Rumors fly in the absence of news. Therefore, we
    must give the people the most accurate possible
    news, promptly and completely.
  • Announce early
  • Be transparent
  • Listen to the public
  • Show empathy

53
How do we address a rumor?Messaging
  • Simply denying a rumor does not eliminate
    ambiguity it may even increase it.
  • No comment increases
  • ambiguity.
  • Silence REALLY increases ambiguity.

54
Thank you!Questions?
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